2011年全国碘缺乏病病情监测结果分析  

National iodine deficiency disorders： an analysis of surveillance data in 2011

作　　者：刘鹏[1] 苏晓辉[1] 申红梅[2] 孟凡刚[1] 范丽珺[1] 刘守军[1] 孙殿军[2] 

机构地区：[1]哈尔滨医科大学中国疾病预防控制中心地方病控制中心碘缺乏病防治研究所,150081 [2]哈尔滨医科大学国家卫计委病因流行病学重点实验室、黑龙江省普通高校病因流行病学重点实验室,150081

出　　处：《中华地方病学杂志》2015年第3期181-185,共5页Chinese Journal of Endemiology

基　　金：中央补助地方公共卫生专项资金地方病防治项目（2011）;志谢 文中所用的监测数据来自全国的31个省份和新疆生产建设兵团

摘　　要：目的 了解全国碘缺乏病防治工作现状,评估我国31个省份及新疆生产建设兵团（简称兵团）持续消除碘缺乏病进展.方法 2011年,在我国的31个省份及兵团按人口比例概率抽样法进行抽样,每个省份及兵团各抽取30个抽样单位.在除外水碘含量＞ 150 μg/L的乡镇后,采用单纯随机抽样方法,从上述每个抽样单位中抽取1所小学,每个小学抽取40名8～ 10岁儿童,检测儿童甲状腺容积;在40名儿童中抽取12名儿童检测尿碘,并检测儿童家中食用盐盐碘及家庭人均日食盐摄入量.在小学校所在地附近选择3个乡（镇、街道）,每个乡（镇、街道）抽取5名孕妇和5名哺乳妇女,检测孕妇和哺乳妇女尿碘.在调查地所在村按东、西、南、北、中各抽取1份饮用水水样,如为集中式供水地区,则采集2份末梢水水样进行水碘测定.儿童甲状腺检查采用B超法,依据《地方性甲状腺肿诊断标准》判定;尿碘测定采用砷铈催化分光光度法（WS/T 107-2006）;水碘测定采用国家碘缺乏病参照实验室推荐方法;盐碘测定采用制盐工业通用试验方法（GB/T13025.7-1999）中的直接滴定法,川盐及其他强化食用盐采用仲裁法;儿童家庭人均日食盐摄入量采用3日称量法.判定标准：①尿碘：儿童尿碘＜ 100μg/L为碘不足,100～199 μg/L为碘适宜,200～299 μg/L为大于适宜量,≥300 μg/L为碘过量;②碘盐（GB 5461-2000）：合格碘盐含碘量为（35±15） mg/kg,＜5 mg/kg为非碘盐,5～＜ 20 mg/kg或＞50 mg/kg为不合格碘盐.采用全国第六次人口普查的总人口数对统计数据进行校正.结果 全国31个省份及兵团平均儿童甲状腺肿大率为2.4％,明显低于国家碘缺乏病消除标准（＜5％）.碘盐覆盖率为98.0％、合格碘盐食用率为95.3％,达到了国家碘缺乏病消除标准（≥95％、＞90％）.盐碘中位数为30.2 mg/kg.儿童、孕妇、哺乳妇女尿碘中位数分别为238.6、184.4、174.4Objectives To understand current situation in national prevention and control of iodine deficiency disorders （IDD）,and to evaluate the progress in eliminating IDD in 31 provinces and Xinjiang Production and Construction Corps （Corps） in China.Methods In 2011,30 units were sampled in each of 31 provinces and Corps in China based on the sampling method of Probability Proportional to Size.After excluding townships of water iodine level higher than 150 μg/L,1 primary school was chosen in each unit,by the randomized sampling method,40 students in cach school were sampled for examining their thyroid volume,among them,12 students were tested for their urinary iodine level and for their household salt iodine level and per capital daily salt intake.Near the location of these primary schools,3 townships were chosen,5 pregnant women and 5 lactating women in each township were sampled to test their urinary iodine level.Besides,1 water sample was sampled according to the location in each village （east,west,south,north,and middle） in non-central water supplying villages,and 2 tap water samples in central water supplying villages.The ultrasound was used to detect goiter size according to the diagnostic criteria for endemic goiter; As3＋-Ce4＋ catalytic spectrophotometry using ammonium per sulfate digestion （WS/T 107-2006） was used to test the urinary iodine level; the testing method recommended by the National Iodine Deficiency Disorders Reference Lab was applied to test the water iodine level,the direct titration method among the generic methods of iodide testing for salt production industry （GB/T 13025.7-1999） was used to determine the salt iodine level; and the arbitration method was adopted for quantitative determination in case of well salt or special salts and the salt intake was estimated based on three-day weighed food record.Evaluation standards are as follows：urinary iodine level of children：deficient is the median of urinary iodine （MUI） less than 100 μg/L,adequate is MUI at 100-199 μ

关 键 词：碘 缺乏症 儿童 妇女 尿 食用盐 流行病学研究 

分 类 号：R599[医药卫生—内科学]